The Continuing Healthcare (CHC) Checklist: Detailed Explanation

The NHS Continuing Healthcare (CHC) Checklist is the first step in the assessment process for determining whether an individual might be eligible for CHC funding. This initial screening tool is designed to be broad and inclusive, ensuring that all individuals with potential healthcare needs are considered for a full assessment.

Here's a closer examination of the Checklist, its components, and its significance in the CHC funding process.

Purpose of the Checklist

The primary purpose of the Checklist is to identify individuals who require a full assessment of their healthcare needs by a multidisciplinary team. It is intended to be a quick and efficient screening to ensure that no one who could be eligible for CHC funding is overlooked.

Components of the Checklist

The Checklist assesses needs across several domains, each representing different aspects of care and support. The domains included are:

• Breathing: This domain assesses the individual's needs related to respiratory function, including any assistance required for breathing, the presence of any respiratory conditions, and their impact on overall health. 

• Nutrition - Food and Drink: Evaluates the individual's needs concerning nutritional intake, including risks associated with swallowing, the need for artificial feeding methods, and dietary management to prevent malnutrition or dehydration.

• Continence: Addresses the individual's ability to manage continence of bladder and bowel, the impact of any incontinence, and the need for interventions or support.

• Skin and Tissue Viability: Assesses the risk and management of pressure ulcers, the condition of the skin, and the necessity for wound care or prevention measures.

• Mobility: Evaluates the level of assistance required for mobility, including the ability to move around safely, use of mobility aids, and risks related to falls.

• Communication: Looks at the individual's ability to communicate effectively, considering challenges related to speech, hearing, visual impairments, and the need for alternative communication methods.

• Psychological and Emotional Needs: Assesses the support required for managing psychological conditions or emotional distress, including anxiety, depression, or behavioural challenges.

• Cognition: Evaluates cognitive function, including memory, understanding, and the ability to make informed decisions about care and treatment.

• Behaviour: Reviews challenges related to behaviour that may be disruptive or harmful to the individual or others, necessitating specialised interventions.

• Drug Therapies and Medication: Assesses the complexity of medication regimes, monitoring for side effects, and the impact of medication on the individual's overall care needs.

• Altered States of Consciousness: Considers the frequency and impact of episodes such as seizures, fainting spells, or periods of altered consciousness on the individual's safety and care needs.

• Other Significant Care Needs: Provides space to document any other care needs that don't fit neatly into the above categories but are significant for the individual's wellbeing.

Scoring and Outcomes

Each domain in the Checklist is scored according to the severity and complexity of the individual's needs. The scoring system typically categorises needs as "No Needs", "Low", "Moderate", "High", "Severe", or "Priority". The overall outcome of the Checklist determines whether the individual proceeds to a full CHC assessment.

Conclusion

The NHS CHC Checklist is a critical tool in the initial screening for Continuing Healthcare funding, designed to capture a broad range of healthcare needs across multiple domains. Understanding the components and purpose of the Checklist is essential for individuals and their families navigating the CHC funding process. By providing a detailed look at what's included in the Checklist, we aim to demystify this step and empower individuals with the knowledge needed to pursue the care and support they require.

Apex Health Associates has a team of CHC specialist nursing experts who can assist patients and their families applying for CHC or appealing decisions. 

Author

Scott Harding-Lister

Scott is a qualified nurse and solicitor. He was a senior nurse within the NHS before leaving to pursue a career as a solicitor in City practices. In 2013 he set up Apex Health Associates and the expert witness practice has gone from strength to strength. Scott is a medico-legal expert, a nursing expert, and head of practice at Apex.